ESG-GATED SPECT WITH USAGE OF STRESS-REST PROTOCOL AS A NON-INVASIVE METHOD FOR SELECTION OF TREATMENT STRATEGY IN PATIENTS WITH STABLE CORONARY ARTERY DESEASE
Keywords:myocardial perfusion imaging, coronary artery disease, stable CAD
Introduction. Myocardial perfusion imaging (MPI), namely, a single-photon emission computed tomography with ECG synchronization (ESG-gated SPECT), is currently the best confirmed non-invasive test for evaluating myocardial perfusion. The aim of the study was to determine the features of localization, extent, severity and reversibility of reduced left ventricular myocardial perfusion in patients with stable coronary artery disease (CAD) by performing ESG-gated SPECT under the stress-rest protocol.
Materials and methods. The study conducted a retrospective analysis of the results of examination of 38 patients (30 men, 8 women) aged 50 to 64 with stable CAD. Stress and rest ESG-gated SPECT (20 patients) and SPECT/CT (18 patients) using 99mTc-MIBI were performed. A one-day stress-rest protocol was used on all of patients.
Results. Areas of reduced radiopharmaceutical fixation were detected in 33 patients (86.8%), while in phase I (stress) they were detected in 33 patients, and in 28 patients (34.2%) in phase II (rest). In 14 (36.8%) patients, summed stress score (SSS) exceeded 8, which indicated a high probability of CAD, a moderate risk of myocardial infarction (MI) and cardiac death. In 15 (39.5%) patients, SSS was 5-8, indicating a high probability of CAD, a moderate risk of MI, and a low risk of a sudden cardiac death. In the remaining 9 (23.7%) patients, the probability of CAD and MI was considered low (SSS was less than 5 points)
Conclusions. MPI in patients with suspected CAD and with stable angina is a safe and effective tool for early detection of the left ventricular myocardial perfusion disorder at the microcirculatory level.
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